Opioid substitution treatment in prison and post-release: Effects on criminal recidivism and mortality

Monograph no. 37

Opioid substitution treatment (OST) is an effective treatment for heroin dependence that is increasingly available in correctional settings globally; in 2009, at least 29 countries offered OST in at least one correctional institution (Larney & Dolan 2009). In Australia, OST is available in prisons in all jurisdictions, albeit with limitations on treatment access in some jurisdictions (AIHW 2010a). One rationale that is often given in support of prison OST is that it reduces post-release criminality; however, the evidence for this proposition is equivocal. Another rationale for prison OST is that it will reduce the risk of death by drug overdose in the post-release period. The aims of the studies presented in this report are to assess the effects of prison OST on re-incarceration, criminal convictions and mortality.